Provider Demographics
NPI:1407988900
Name:JONES, THALIA R (MA, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:THALIA
Middle Name:R
Last Name:JONES
Suffix:
Gender:F
Credentials:MA, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:546 PLEASANT AVE
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-5711
Mailing Address - Country:US
Mailing Address - Phone:913-651-7747
Mailing Address - Fax:
Practice Address - Street 1:546 PLEASANT AVE
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-5711
Practice Address - Country:US
Practice Address - Phone:913-772-7747
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS1191235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist